Prior Auth Required
19396 - Preparation of moulage for custom breast implant
This procedure appears on the selected insurer prior authorization source.
Prior authorizationPrior Auth Required
Procedure / ServicePreparation of moulage for custom breast implant
Procedure / Service Description
Revision of peri-implant capsule, breast, including capsulotomy, capsulorrhaphy, and/or partial capsulectomy - autologous reconstruction or significant capsular revision combined with soft tissue excision in implant-based reconstruction) 19396 Preparation of moulage for custom breast implant 20912 Cartilage graft; nasal septum 20930 Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in
Likely documents
- Confirm benefit details
- Submit clinical notes if requested by the plan
Next actions
- Confirm the current plan policy before submission.
- Use the insurer authorization workflow for this listed code.